First Thoughts: Health care takes center stage

Health care’s two-year anniversary, but White House is quiet on the subject. … Supreme Court takes it up next week and will determine its fate by June. Whatever the outcome, it will have a big impact on the president’s legacy. If it’s upheld, it’s good for him; if not, it’s bad. It’s as simple as that. … Dems still have a message problem on it … But so does Romney despite his efforts today … Did Santorum go too far with his criticism of Romney? … Biden will again name names when he talks to seniors in Florida about Social Security and Medicare … Previewing the Bayou battle Saturday … Plouffe on Meet the Press.

Republican Conference Chairman Rep. Jeb Hensarling, R-Texas, and fellow GOP House members meet with reporters on Capitol Hill in Washington, Thursday, March 22, 2012, after the House voted along party lines to repeal a Medicare cost-control board that's part of President Barack Obama's health care overhaul law. From left are, Rep. Joe Barton, R-Texas, Hensarling and Rep. Bill Cassidy, R-La.

*** Health care takes center stage: Two years ago today, surrounded by legislators and cameras, President Obama signed the health care act into law. Today, there won't be a commemoration but the real action is NEXT week. The fate of the president's signature legislation will be in the hands of the Supreme Court, which begins oral arguments in the case Monday. The country remains split to slightly more unfavorable on the law, and how the Supreme Court will decide is anybody's guess. But it's clear whatever the court decides in June could have a big impact on the presidential race. There are a lot of different ways to slice it and speculate what the various potential outcomes could mean, but no one's EXACTLY sure how it will all play out. Certainly, if the mandate is struck down, that will be a major black mark for the president. Anything other than it being upheld is bad for the president. It’s simple: The court upholds it, it’s good for the president. If it doesn’t, it’s bad for him.

*** Public will likely still be swayed by outcome: While the public’s views of the Supreme Court have become slightly more polarized again, there’s still a good chunk of folks who don’t view it as ideologically as partisans do and how they rule will probably sway them. This case will draw a ton of interest across the country. It’s one of the reasons why this is the hottest ticket in town. Bloomberg/Business Week looks at efforts by everyone from congressmen to lobbyists to think tank fellows trying to get in and work any contact they can to snatch one of the 400 tickets available to WATCH oral arguments next week. Rep. Michele Bachmann (R-MN), very enthusiastically on TODAY, announced she had gotten a ticket.

*** Still a message problem for the Democrats: This fight over health care is not just an ideological and rhetorical one; it's also about big money. And a war has been waged on the TV airwaves with more than a quarter billion dollars spent -- $262 million -- on health-care-related TV ads since its passage, according to an analysis by Kantar Media Campaign Media Analysis Group. Opponents have outspent supporters 2-to-1 and have focused their advertising in swing states. Supporters have spent their money on national TV and California markets. But look at that ratio again. Opponents have outspent supporters 2-1 and supporters want to know why the public is slightly unfavorable toward the plan? It doesn’t take a rocket scientist to figure out that health care wasn’t communicated well by this White House – and it’s doubling down lately by not selling it. Though his campaign is using health care to try and appeal to women, the president is not selling himself very much or very well. It’s clearly one of those things they don’t want a discussion about, but with Romney as the nominee, maybe they’re banking on the fact they won’t have to have a long discussion about it.

*** Romney in focus, too: Romney, who signed his own health law in Massachusetts with a mandate, will be in focus today, too. He’s trying to keep the focus on President Obama with an op-ed today in USA Today, entitled, “Why I’d repeal ObamaCare;” his campaign sent out a press release this morning called, “Two years of broken promises from ObamaCare;” and his event today in Metairie, La., is called: "Repeal & Replace Obamacare.” Rick Santorum has said that if Romney is the nominee, then health care is off the table as an issue, and for the most part, he’s right. One reason, as National Journal points out today: “It was in 2009 that Romney penned a now-infamous op-ed in the same paper [USA Today] suggesting that President Obama would do well to follow Massachusetts’ model in creating a national health plan, even going so far as to mention that his state used ‘tax penalties’ to encourage the uninsured to buy insurance.” And NPR points this out: “Perhaps it's ironic that one of the most articulate spokesmen for the individual mandate is someone who is currently campaigning for the repeal of the federal health law — GOP presidential candidate Mitt Romney.”

*** Did Santorum take it too far? But did Santorum go too far on another criticism of Romney yesterday? He said, reelecting Obama would be BETTER than electing Romney. “If you're going to be a little different, we might as well stay with what we have instead of taking a risk with what may be the Etch-A-Sketch candidate of the future,” he said. Gingrich, who also continued to use Etch A Sketch (showing up with a pink one and using a toy gator to chomp one), fired back at Santorum, saying any of the candidates running would be better than Obama. And Romney, whose campaign yesterday penned a memo calling Santorum Obama’s “most valuable player,” said on Hugh Hewitt’s radio show that Santorum was “desperate.” “Desperate polls call for desperate pols,” Romney said. On Etch A Sketch, by the way, he said the timing was “not ideal,” coming right after a win in Illinois and he labeled it a “gaffe.” “This wasn't me speaking,” Romney said. “This was Eric. And you know, everybody's going to make a gaffe now and again. I've certainly made my share of them, and I'm sure others will.” Ouch. He again said the context of what aide Eric Fehrnstrom was talking about was “organization.” But the questioner asked about ideology. Did Fehrnstrom not hear the question? Unlikely.

The Daily Rundown's Chuck Todd talks about Rick Santorum's comments to a crowd of supporters, in which he said President Barack Obama is better than Mitt Romney.

*** Biden and third rail: In Florida today at 12:20 pm ET, Vice President Biden delivers the second of his campaign speeches framing the general election for Team Obama (the first was in Toledo, Ohio, on the auto bailout). Today’s topic in senior-citizen-rich Florida: Medicare and Social Security. As the Obama campaign previewed in a memo yesterday, “Biden will discuss the importance of protecting Social Security and Medicare in Florida, a state where Social Security and Medicare beneficiaries make up about 20 percent of the population.” Biden will say, according to excerpts: “The American people won't be fooled. They know there's a fundamental difference between us and the Republicans. We believe in strengthening Medicare. They don't.” And he will again name Romney, going after him for supporting “Cut, Cap, and Balance.” Biden will say, “”Let’s cut through it and say it in plain English. The ‘cut’ is cutting Social Security. The ‘cap’ is putting a cap on what we ask the wealthiest Americans to pay in taxes. And the ‘balance’ is balancing the budget on the backs of seniors and middle class Americans.”

*** Louisiana cookin’: Louisiana Republicans go to the polls Saturday, where Rick Santorum is the favorite, and Gingrich concedes that he’ll likely come in third. Per NBC’s John Bailey, 20 of the state’s 46 delegates are at stake Saturday. Polls close at 9:00 pm ET. It’s a closed primary, meaning only registered Republicans can vote. Louisiana allots its delegates proportionally with candidates needing at least 25% of the vote to get delegates. But all of the votes for candidates receiving less than 25% will go toward delegates designated as uncommitted; those delegates do NOT get reallocated to those that DID received 25% or more (it’s a delegate blow to the winner). So if Candidate A gets 40%, Candidate B gets 35%, and no other candidate exceeds 25%, then Candidate A will get 40% of the delegates, Candidate B will get 35% of the delegates, and 25% of the delegates will be designated uncommitted. Of the state’s 26 remaining delegates, three are RNC delegates and the other 23 will be elected at the party’s state convention in June. All 26 are unpledged.

*** What to watch: In 2008, Louisiana’s primary took place on Feb. 9, just days after Mitt Romney withdrew from the race, Bailey reports. Mike Huckabee narrowly won with 43%, a one-point margin over runner-up John McCain. Turnout topped 160,000 (161,169 to be exact). Louisiana reports its results by parish and had only four parishes with more than 10,000 GOP voters last cycle – East Baton Rouge (31,343), Jefferson (16,279), St. Tammany (13,364), and Caddo (10,612). These four parishes accounted for 44% of the vote and broke mostly for McCain despite Huckabee’s statewide victory. East Baton Rouge (Baton Rouge), Jefferson (New Orleans), and St. Tammany (across Lake Pontchartrain from New Orleans) went for McCain and Caddo Parish (Shreveport) went for Huckabee. The state broke down roughly along geographic lines, with McCain winning Baton Rouge, Lafayette, New Orleans and the rest of the state’s southeastern portion. Huckabee won the middle and northern block of the state, including Shreveport.

*** In case you forgot about him, Paul is back: After a weeklong absence, Paul holds two campaign events today in Louisiana. Also on the trail, per NBC’s Adam Perez, Paul isn’t the only one in Louisiana: Romney hits Metairie and Shreveport… Santorum stumps in West Monroe, Shreveport, and Pineville… And Gingrich visits Port Fourchon and Kenner.

*** On “Meet the Press” this Sunday: NBC’s David Gregory interviews White House adviser David Plouffe.